Comparative study between breast MRI (diffusion & ADC value) and ultrasonography in postoperative patients with breast cancer

Abstract

Breast cancer is not only a leading cause of death among women but also carries a high risk of recurrence. Early detection of local recurrence can improve patients’ survival. This can be attributed by means of close clinical and imaging follow-up which is considered an important component of breastconserving strategy. Women with a history of breast cancer are at risk for developing local recurrences, a second ipsilateral breast cancer, or contralateral breast cancer. The incidence of local recurrence is between 1 and 2% per year, with most of the recurrences occurring in the first 5 years. Many benign changes can be noticed in the postoperative breast as {resolving edema, seroma, hematoma, fat necrosis, and abscess formation especially post chemotherapy at the operation site} all of which are expected findings. Yet recurrence is not an exception. Thus it is mandatory to identify imaging findings that are benign or expected for short-interval imaging follow up in order to minimize unnecessary intervention, as well as to appropriately pick up suspicious lesions aiming for proper diagnosis and in turn management of malignant cases. DWI is a safe, fast, noncontrast sequence that can be easily added to all MRI machines, with no significant lengthening of the examination time. In our study we tried to assess and compare the MRI diffusion and ultrasonographic findings in postoperative breasts with breast cancer in order to differentiate between the accepted postoperative sequelae and tumor residual or recurrence. Forty female patients were included in this prospective study. All cases underwent either CBS or MRM with or without reconstruction, at least 6 months before doing their MRI with two exceptions where the two female patients presented with pain in the early postoperative period, around 3 and 4 months. All cases were suspected for either recurrence or post-operative complication by US examination. Breast US were reviewed for all patients